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ADDICTION Flashcards

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1
Q

What is addiction

A

A disorder in which an individual takes a substance or engages in a behaviour that is pleasurable but eventually becomes compulsive with harmful consequences.

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2
Q

What 3 things is addiction marked by

A

Physiological and/or psychological dependence, tolerance and withdrawal

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3
Q

What is physical dependence

A

A state of the body due to habitual substance abuse which results in a withdrawal syndrome when use of the drug is reduced or stopped.

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4
Q

What is psychological dependence

A

A compulsion to continue taking a substance (or continue performing a behaviour) because its use is rewarding.

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5
Q

What is a consequence of psychological dependence

A

The person will keep taking the substance or engaging in a behaviour until it becomes a habit despite the harmful consequences

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6
Q

What is tolerance

A

A reduction in response to a substance, so that an addicted individual needs more to get the same effect.

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7
Q

What causes tolerance

A

Repeated exposure to the effects of a substance

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8
Q

What is behavioural tolerance
Give an example

A

It happens when an individual learns through experience to adjust their behaviour to compensate for the effects of a substance.
An alcoholic learns to walk slower so they dont fall when drunk.

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9
Q

What is cross-tolerance
Give an example

A

Developing a tolerance to one type of substance can reduce sensitivity to another type.
Alcohol and benzodiazepines

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10
Q

What is a risk factor

A

Any internal or external influence that increases the likelihood a person will start using addictive substances or engaging in addictive behaviours

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11
Q

Name the 5 risk factors for addiction

A
  1. Genetic vulnerability
  2. Stress
  3. Personality
  4. Family influences
  5. Peers
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12
Q

Explain how genetic vulnerability is a risk factor for addiction

A

People don inherit an addiction itself but a predisposition (vulnerability) to dependence.
Genes may determine the activity of neurotransmitter systems in the brain, which affect behaviours such as impulsivity which predispose a person to dependence.

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13
Q

Explain how stress is a risk factor for addiction
Does the stress have to be going on now

A

People who experience stress may turn to drugs as a form of self-medication
Stress includes present and past events

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14
Q

Explain how personality is a risk factor for addiction
Is there such thing as an ‘addictive personality’

A

Individual personality traits such as hostility and neuroticism may increase the risk of addiction.
Probably not.

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15
Q

Explain how family influences is a risk factor for addiction

A

Living in a family which uses addictive substances and/or has positive attitudes about addictions increases a person’s likelihood of becoming addicted

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16
Q

Explain how peers is a risk factor for addiction

A

As children get older, peer relationships become more important, even more than family.
Even if you dont use the drug your attitude towards them may be influenced

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17
Q

What is one limitation to risk factors

A

By focusing on one individual risk factor you may ignore the effect of interactions and also the positive effects.

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18
Q

Does one risk facto cause addictions

A

No
Combinations of risk matter more than single factors.

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19
Q

Who researched combinations of risk factors

A

Linda Mayes and Nancy Suchman (2006)

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20
Q

What did Mayes and Suchman conclude about combinations of risk factors

A

Different combinations partly determine the nature and severity of an addiction.

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21
Q

Are all of the risk factors mentioned always negative
Explain
Which risk factor is never positive

A

No
Personality traits, genetic characteristics, family and peer influences can reduce risks of addiction.
Stress

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22
Q

What is a more realistic way to view risk factors

A

View risk factors as multiple ‘pathways’ to addiction which include different combinations interacting and some having a positive effect.

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23
Q

What is one strength of looking at risk factors together

A

They point to the overriding interaction with genes.

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24
Q

Most risk factors are proximate. What does this mean
Example

A

They act as an immediate influence on addiction
High stress levels directly increase addiction risk as does the personality trade of novelty-seeking.

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25
Q

Who conducted research on the central tole of genes in addiction

A

Rey et al. (2009)

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26
Q

What did Rey et al. Conclude on the central role of genes in addiction

A

How we respond to stress and the extent to which we seek novelty are both partly genetic.

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27
Q

What is the most common ultimate risk factor

A

Genetic vulnerability.

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28
Q

What is withdrawal syndrome

A

A set of symptoms that develop when an addicted person abstains from or reduces their substance abuse.

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29
Q

Are withdrawal symptoms the same for all drugs
Are withdrawal symptoms predictable

A

No
Yes

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30
Q

What is the common link between substance and withdrawal symptoms
Give an example

A

The symptoms are almost always the opposite of the ones created by the substance
Smoking relaxes you so when you stop anxiety is heightened

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31
Q

Give an example of an active ingredient

A

Nicotine
Alcohol

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32
Q

What does the existence of withdrawal indicate

A

Physical dependence has developed

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33
Q

Why does withdrawal symptoms cause further addiction

A

An addicted person experiences withdrawal whenever they dont have the addictive substance
These withdrawal symptoms are unpleasant and cause discomfort
Motivation to continue with the drug is avoidance of withdrawal syndrome

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34
Q

Taking a substance to avoid withdrawal syndrome is called

A

A secondary form of psychological dependence

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35
Q

Name the two phases of withdrawal

A
  1. The acute withdrawal
  2. The prolonged withdrawal
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36
Q

How long does acute withdrawal last

A

Begins within hours
Deminished over days

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37
Q

How long does the prolonged withdrawal phase last

A

Weeks, months and even years

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38
Q

What are the symptoms of acute withdrawal

A

Intense cravings reflecting strong physiological and psychological dependence

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39
Q

What are the symptoms for prolonged withdrawal phase
Example
What does this mean

A

The person becomes highly sensitive to the cues they associate with the substance.
E.g. lighters, rituals, locations
This is why relapse is so common.

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40
Q

What type of dependence does withdrawal indicate

A

Physical dependence

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41
Q

What are the two plausible direct mechanisms that create a genetic vulnerability to addiction

A

D2 receptor
Nicotine enzyme (CYP2A6)

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42
Q

Explain how dopamine transmission is effected
What is this controlled by

A

By the number of dopamine receptors
This number is genetically controlled

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43
Q

What type of receptor is D2

A

A Dopamine receptor

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44
Q

What is the correlation between D2 and addiction
Explain how it leads to addiction

A

People who are addicted have been found to have an abnormally low number of D2 receptors.
Fewer receptors means less dopamine activity, so using drugs is a way of compensating for this deficiency

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45
Q

Who researched Nicotine enzyme CYP2A6

A

Micheal Pianezza et al. (1998)

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46
Q

What did Micheal Pianezza et al. Find out about the enzyme CYP2A6
What does this mean for addiction

A

Some people lack a fully functioning enzyme which metabolises nicotine.
These people smoke significantly less than those smokers with the fully functioning version.

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47
Q

What is the nicotine enzymes scientific name

A

CYP2A6

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48
Q

What is the expression of the CYP2A6 enzyme determined by

A

Genetics

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49
Q

Who highlighted the role of adverse childhood experiences in later addiction

A

Susan Andersen and Martin Teicher (2008)

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50
Q

What does ACEs stand for

A

Adverse Childhood Experiences

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51
Q

What do Anderson and Teicher argue about stress and ACEs

A

Early experiences of severe stress have damaging effects on a young brain n a sensitive period of development.
This creates vulnerability to later stress.

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52
Q

How does Andersen and Teichers argument link to addiction

A

Further experiences in adolescence and adulthood trigger the early vulnerability and make it more likely that a person will self-medicate with drugs or other behavioural addictions

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53
Q

Is there such thing as a generally addictive personality
What type of personality is linked to addiction

A

No
Linked to disordered personality.

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54
Q

What disorder is linked mostly to addiction
Who says this

A

Antisocial personality disorder (APD)
Petry (2002)

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55
Q

Who argues that APD is a causal risk for addiction

A

Lee Robins (1998)

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56
Q

What is Lee Robins argument for APD and addition

A

That APD is a causal risk factor because having APD means that a person breaks social mores, is impulsive and may behave criminally

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57
Q

Why will people with APD try drugs
When are they most likely to do it

A

Drug-taking offers a combination of norm-breaking, criminal activity whist satisfying desires
At a young age

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58
Q

What is the study for family influences on addiction

A

Jennifer Livingston et al. (2010)

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59
Q

What did Jennifer Livingston find on family influences and addiction to alcohol

A

Final-year high-school students who were allowed to drink alcohol at home were significantly more likely to drink excessively the following year at college.

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60
Q

What role does adolescent’s perception play in addiction

A

Adolescents who believe that their parents have little or no interest in monitoring their behaviour are more likely to develop an addiction.

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61
Q

Who suggested that there are 3 major elements to peer influence a s a risk factor for alcohol addiction

A

Mary O’Connell et al. (2009)

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62
Q

What are the 3 major elements to peer influence as a risk factor for alcohol addiction

A
  1. An at-risk adolescent’s attitude and norms about drinking are influences by associating with peers who use alcohol.
  2. Experienced peers provide more opportunities for the at-risk individual to drink
  3. An individual overestimates the amount their peers are drinking, they drink more to keep up with the perceived norm
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63
Q

What is the underlying matter of peers and addiction

A

A group normally that favours rule-breaking generally
Substance addiction is one instance of this

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64
Q

What is a strength of genetic vulnerability as a risk factor for addiction

A

Support from adoption studies

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65
Q

Who carried out the adoption studies focusing on genetic vulnerability for addiction

A

Kenneth Kendler et al. (2012)

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66
Q

What was Kendlers method when investigating adoptive studies and addiction

A

He used data from the National Swedish Adoption Study.
They looked specifically at adults who had been adopted away, as children, from biological families in which as least one parent had addiction.

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67
Q

What was Kendlers findings on genetic vulnerability and addiction

A

The children later has a significantly greater risk of developing an addiction themselves, compared with adopted-away individuals with no addicted biological parent.

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68
Q

What other research supports the link between genetic vulnerability and addiction

A

Twin studies

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69
Q

What is one limitation of reserach into stress as a risk factor for addiction

A

The issue of causation

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70
Q

What have many studies show about the link between stressful experiences and addiction

A

That there is a positive correlation

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71
Q

What is the key matter for stress as a risk factor for addiction
Explain via example

A

It matters whether stress or addiction comes first
Some people become addicted with not a significantly stressful experience. Their addiction causes greater levels of stress due to negative effects.
This would still produce a positive correlation but addiction caused the stress.

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72
Q

What is one strength of personality as a risk factor for addiction

A

Support for the link between addiction adn APD

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73
Q

What link between APD and alcohol dependence is shown in many studies

A

That they are co-morbid

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74
Q

Who investigated whether APD is actually a causal factor for addiction

A

Miriam Bahlmann et al. (2002)

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75
Q

What was Bahlmann’s method for investigating APD and addiction

A

They interviewed 55 alcohol-dependent people

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76
Q

What was Bahlmann’s findings on alcohol addiction and APD

A

Of 55 interviewed 18 weer also diagnosed with APD.
For these 18 participants APD developed 4 years before their alcohol addiction on average.

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77
Q

What is one strength for family influence as a risk factor for addiction

A

Research support

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78
Q

Who investigated family influences as a cause for addiction

A

Bertha Madras et al (2019)

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79
Q

What was Madras findings on family influences as a risk factor for addiction

A

Found a strong positive correlation between parents use (abuse) of cannabis and their adolescents use of cannabis, nicotine, alcohol and opioids.

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80
Q

What are the two reasons behind family influences leading to addiction

A

May be that adolescents observe their parents using a specific drug and model this behaviour.
May also infer that their parents approve of drug use, so go on to use other drugs.

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81
Q

What is one strength of peers as a risk factor for addiction

A

Real-world application

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82
Q

Who is doing an intervention to change mistaken beliefs about how much peers are drinking

A

SNMA
Social Norms Marketing Advertising

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83
Q

What is SNMA doing to change mistaken beliefs on how much peers drink
Examples with fact

A

Using mass media advertising to provide messages and statistics about how much people really drink

Beer mats, posters and leaflets in a Student Union bar with messages such as ‘Students overestimate what others drink by 44%’

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84
Q

What is neurochemistry

A

Relating to chemicals in the brain that regulate biological and psychological functioning

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85
Q

What is dopamine

A

A neurotransmitter that generally has an excitatory effect and is associated with the sensation of pleasure

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86
Q

Who came up with the desensitisation hypothesis of nicotine addiction

A

John Dani and Steve Heinemann (1996)

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87
Q

What neurotransmitter plays a key role in all nervous system activity and is key in the role of dopamine

A

Acetylcholine (ACh)

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88
Q

Where can ACh receptors be found

A

On the surface of many neurons in the central nervous system

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89
Q

What is the subtype of ACh receptor called

A

Nicotinic acetylcholine receptor (nAChR)

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90
Q

What is special about nAChR receptors

A

They can be activated by both dopamine and nicotine

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91
Q

What occurs at the nAChRs when a person smokes

A

When nAChRs are activated by nicotine molecules, the neuron transmits dopamine.
This is immediately followed by a shutdown.
Within seconds the nAChRs shut down and temporarily cannot respond to any neurotransmitters.
The neurone is desensitised and this leads to downregulation, a reduction in the number of active neurons because fewer of them are avaliable.

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92
Q

What is a desensitised neuron

A

One that is shutdown and temporarily cannot respond to any neurotransmitters

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93
Q

What is downregulation

A

A reduction in the number of active neuron’s because fewer of them are avaliable

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94
Q

Where are nAChRs concentrated

A

In the ventral tegmental area (VTA) of the brain.

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95
Q

When nAChRs are stimulated by nicotine how and where is dopamine transmitted

A

Dopamine is transmitted along the Mesolimbic pathway
To the Nucleus accumbens (NA)

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96
Q

What does the movement of dopamine into the Nucleus Accumbens trigger

A

The release of more dopamine from the Nucelus Accumbens into the Frontal Cortex

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97
Q

When dopamine is being transmitted along the mesolimbic pathway where else is it being transmitted to and how

A

Directly to the frontal cortex
On the mesocortical pathway

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98
Q

Name both the pathways to the frontal cortex and where the dopamine is flowing from in the brain

A

Ventral tegmental area ——mesolimbic pathway——> Nucelus accumbens ——> Frontal Cortex
Ventral tegmental area ——Mesocorical Pathway——> Frontal Cortex

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99
Q

What are both of the pathways part of

A

The dopamine reward system

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100
Q

What activates the dopamine reward system

A

Nicotine

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101
Q

What are the pleasurable effects of nicotine

A

Mild euphoria, increased alertness, reduction of anxiety

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102
Q

What happens to nicotine and nAChRs and dopamine neurons when someone doesnt smoke for a long period of time
- KEY WORDS

A

Nicotine disappears from their body
The nAChRs become functional again, so dopamine neuron’s resensitise and more become available
Upregulation

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103
Q

What is upregulation

A

The nAChRs become functional again, so dopamine neuron’s resensitise and more become available

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104
Q

Explain withdrawal in terms of nAChRs

A

During resensitisation nAChRs become over stimulated by ACh - as there is no nicotine to bind
NAChRs are most sensative at this point

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105
Q

When are nAChRs most sensative

A

During resensitisation

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106
Q

Why is the first cigarette of the day most enjoyable

A

It reactivates the dopamine reward system

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107
Q

Describe dependence in terms of nAChRs
Do so through night-time and day-time changes

A

There is a constant cycle of daytime downregulation and night-time upregulation.
This causes longterm desensitisation of nAChRs - causing dependence.

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108
Q

Describe tolerance in terms of nAChRs

A

Continuous exposure of nAChRs to nicotine causes permanent changes to brain neurochemistry
It decreases the number of active receptors.
Tolerance therefore develops as a smoker must smoke more to get the same effects.

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109
Q

What is one strength of dopamine explanations of nicotine addiction

A

Support from human research

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110
Q

Who has conducted research that supports dopamines explanation of nicotine addiction

A

Joseph McEvoy et al. (1995)

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111
Q

What did McEvoy study - dopamine explanations of nicotine addiction
Method

A

Studied smoking behaviour in people with schizophrenia where were taking the antipsychotic drug Haloperidol.

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112
Q

In McEvoy’s study why did he focus on schizophrenia patients taking Haloperidol

A

Haloperidol is a dopamine antagonist - blocks dopamine receptors in the brain, reducing dopamine transmissions

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113
Q

What was McEvoy’s findings in his reserach on smoking behaviour in people with schizophrenia
Explain

A

The people taking Haloperidol showed a significant increase in smoking.
This is a form of self-medication.
Individuals used the nicotine as a means of increasing their depleted dopamine levels.

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114
Q

What is a counterpoint to research support for dopamine explanations of nicotine addiction

A

Explanations of nicotine that consider only the role of dopamine are limited.
The dopamine system is central but research increasingly shows a complex interaction of several neurochemical systems

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115
Q

Why did research on the other neurochemical systems that may be involved in nicotine addiction

A

Shelley Watkins et al. (2000)

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116
Q

What did Watkins say the other neurochemical systems are

A

Neurotransmitter pathways e.g. serotonin
Endogenous opioids (endorphins)

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117
Q

What is another strength that neurochemistry does

A

Leads to new treatments

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118
Q

Give an example of neurochemistry leading to new treatments

A

Nicotine replacement therapy (NRT)

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119
Q

Name 3 examples of NRT

A

Patches
Gum
Inhalers

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120
Q

How do Nicotine Replacement Therapies work (NRT)

A

They deliver controlled doses of nicotine
Acts neurochemical by binding with nAChRs and mimicking the effects of nicotine, including dopamine release.
Satisfies cravings and allows safe withdrawal.

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121
Q

What is the limitation of the neurochemical explanation

A

It does not fully explain withdrawal

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122
Q

What do withdrawal symptoms mainly depend upon

A

The nicotine blood concentration levels in the body.

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123
Q

Who is the study for neurochemical explanations not fully explaining withdrawl

A

David Gilbert (1995)

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124
Q

What did Gilbert point out about withdrawal not being fully explained by neurochemistry

A

Blood level concentrations do not strongly correlate with the severity of withdrawal symptoms.

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125
Q

What did Gilbert argue instead about what withdrawal depends upon
Example

A

Withdrawal depends much more on environment and personality.
Those who score higher on the personality dimension of neuroticism generally experience worse withdrawal symptoms than those who are emotionally stable/

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126
Q

Who states that some people can smoke without becoming dependent or experience withdrawal

A

Shipman and Paty (2006)

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127
Q

What did shipman and patty state
What is this called

A

Some people smoke without becoming dependent and show no signs of withdrawal
Determinism

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128
Q

Why does shipman and pattys statement contradict the neurochemical explanation for nicotine addiction

A

The neurochemical explanation is biologically determinist suggesting we become addicted due to chemical events.
It suggests nicotine addiction is inevitable.

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129
Q

What is the learning theory

A

A behaviourist explanation based on the mechanisms of classical and operant conditioning such as positive and negative reinforcement.

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130
Q

What type of conditioning is cue reactivity an example of

A

Classical conditioning

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131
Q

Is nicotine a strong reinforcer

A

Yes

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132
Q

Explain how nicotine is a positive reinforcement

A

Nicotine stimulates the dopamine reward system.
When someone has a cigarette they experience mild euphoria which the smoker finds rewarding and positively reinforces their smoking behaviour.

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133
Q

Who stated that positive reinforcement can explain the early stages of smoking

A

George Koob and Michel Le Moal (2008)

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134
Q

What stage of smoking is positive reinforcement involved in

A

The early stages of

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135
Q

What stage of smoking is negative reinforcement

A

A smoker’s continuing dependence on nicotine

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136
Q

Explain how negative reinforcement plays a role in smoking

A

Negative withdrawal symptoms occur when a smoker stops smoking.
The smoker smokes another cigarette which is negative reinforcing because it stops an unpleasant stimulus.

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137
Q

What are the pleasurable effects of smoking known as

A

A primary reinforcer

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138
Q

Why are the pleasurable effects of smoking known as a primary reinforcer

A

It is intrinsically rewarding (not learned) due to its effects on the brain’s dopamine reward system

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139
Q

What are secondary reinforcers

A

Any other stimuli that is present at the same time or just before that become associated with this pleasurable effect.

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140
Q

Give examples of secondary reinforcers for smoking

A

Areas such as pub gardens or smoking areas
Friends who also smoke
Smell of tobacco
A favourite lighter

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141
Q

What do all secondary reinforcers act as?
Why

A

Cues
Because their presence produces a similar physiological and psychological response to nicotine itself.

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142
Q

What are the three main elements of cue reactivity?

A
  1. Subject desire or craving for a cigarette, which is self-reported
  2. Physiological signs of reactivity, including autonomic responses such as heart rate and skin temperature
  3. Objective behavioural indicators such as how many ‘draws’ are taken on a cigarette and how strongly
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143
Q

What is the definition of cue reactivity

A

Cravings and arousal can be triggered in, for instance, nicotine addicts when they encounter cues related to the pleasurable effects of smoking.

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144
Q

What is one strength for the learning approach to addiction

A

Support through animal studies
There is a substantial body of research with non-human animals confirming the role of operant conditioning in nicotine addiction

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145
Q

Who completed a study on operant condition and nicotine addiction

A

Edward Levin et al. (2010)

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146
Q

What was the method to Levins research on operant conditioning

A

Rats could lick two water spouts.
Licking one spout caused an intravenous dose of nicotine.

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147
Q

What was Levins results on his research with rats on operant conditioning and nicotine addiction

A

The rats licked the nicotine-linked waterspout significantly more than often.
The number of licks increased over 24 hrs.

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148
Q

What are the limitations to Levis research on operant conditions and nicotine addiction

A

Human-animal comparisons are flawed because nicotine addiction in humans is more complex due to cognitive factors.
Ethical issues with using animals for experimentation.

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149
Q

What is the positive of using animals in research on conditioning and nicotine addiction

A

The conditioning mechanisms involved in nicotine addiction are the same in humans and other mammals (according to behaviourists)
More ethical to use animals over humans.

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150
Q

What is a strength for cue reactivity and its link to nicotine addiction

A

There is research with humans for the effects of

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151
Q

Who conducted a meta-analysis on cue reactivity in humans for nicotine addiction

A

Brian Carter and Stephen Tiffany (1999)

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152
Q

What did Carter and Tiffany do in their research on cue reactivity and nicotine addiction
What did studies involve

A

Conducted a meta-analysis of 41 studies into cue reactivity
The studies presented dependent, non-dependent and non smokers with images of smoking-related cues.

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153
Q

What was measured in the studies in the meta-analysis conducted by Carter and Tiffany

A

Self-report desire was measured along with indicators of physiological arousal (heart rate)

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154
Q

What was the results of Carter and Tiffany’s meta-analysis on cue reactivity and addiction

A

Dependent smokers reacted most strongly to the cues and reported stronger cravings even when nicotine wasn’t present.

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155
Q

What strength does nicotine treatment programmes prove

A

They are based on classical conditioning principles.

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156
Q

What does aversion therapy use to treat nicotine addiction

A

Countercondition

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157
Q

What therapy uses counterconditoning to treat nicotine addiction

A

Aversion therapy

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158
Q

How is counterconditioning done to treat nicotine addiction

A

It associated the pleasant effects of smoking with an aversive stimuli e.g. an electric shock

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159
Q

Who researched aversion therapy for nicotine addiction
What was the method

A

James Smith (1988)
Smokers gave themselves aversive electric shocks whenever they engaged in any smoking-related behaviours

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160
Q

What was the results of smiths research on counterconditioning
Compare this to the usual rates (2 Facts)

A

After one year 52% of the participants were still abstaining.
Usually 20-25% of people continue not to smoke after deciding to give up.

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161
Q

What is the counterpoint to Smith’s research on counterconditioning as a treatment for nicotine addiction

A

The study did not use a control (placebo) group.
The comparison of the proportion of people who continue not to smoke is not a valid measure of effectiveness.

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162
Q

Who provided evidence in a higher-quality study that the benefits of aversion therapy are relatively short-lived compared to other therapies

A

Hajek and Stead (2001)

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163
Q

What is the negative to aversion therapies compared to others

A

It has a shorter temporal effect.

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164
Q

What is reinforcement

A

A consequence of behaviour that increases the likelihood of that behaviour being repeated.
Can be positive or negative

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165
Q

What is the first component in the learning theory of gambling addiction

A

Vicarious reinforcement
Seeing others be rewarded for their gambling through pleasure, enjoyment and money.

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166
Q

What are the two sources of direct positive reinforcement for gambling

A

Winning money
The adrenaline rush that accompanies a gamble

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167
Q

Explain how gambling can have a negative reinforcement

A

It can be a distraction from aversive stimuli
A distraction from the anxieties of everyday life

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168
Q

What is the overall specific types of reinforcement seen in gambling

A

Partial reinforcement

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169
Q

What is partial reinforcement

A

A behaviour is reinforced only some of the time it occurs
E.g. every tenth time or at variable intervals

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170
Q

What is a sub type of partial reinforcement

A

Variable reinforcement

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171
Q

What is variable reinforcement

A

A type of partial reinforcement in which a behaviour is reinforced after an unpredictable period of time or number of responses.

172
Q

What takes longer under variable reinforcement

A

Learning - it produces the most persistent learning

173
Q

What happens once learning is established in variable reinforcement

A

It is much more resistant to extinction

174
Q

Why does variable reinforcement lead to gambling addictions

A

The gambler learns that they will not win with every gamble, but they will eventually win if they persist.

175
Q

What else can explain why a behavioural action like gambling can be maintained and reinstated after relapse

A

Cue reactivity

176
Q

What are some of the secondary reinforcers a gambler may experience

A

The atmosphere of a betting shop
The colourful look of a lottery scratch card
Sounds of internet betting sites

177
Q

What is one strength for positive reinforcement in gambling

A

Support from research outside the lab situation

178
Q

Who conducted research on positive reinforcement for gambling addiction

A

Mark Dickerson (1979)

179
Q

What was Mark Dickersons method for researching positive reinforcement and gambling addictions

A

He observed the behaviour of gamblers in two betting offices in Birmingham.
He compared gamblers who placed few bets (low-frequency) on horse races with high-frequency betters.

180
Q

What was Dickersons findings for positive reinforcement in gambling addictions
What do they mean

A

High-frequency gamblers were consistently more likely to place their bets in the last 2 minutes before the start of the race.
Suggested that all gamblers find the build-up exciting regardless of the result, especially dependent ones.

181
Q

What is a counterpoint to Dickersons research on positive reinforcement in gambling

A

Methodological shortcomings.
Observed over 14 weeks by 1 observer - no one checking reliability.
Observer bias is not eliminated and findings may be invalid
No inter-observer reliability

182
Q

What is one limitation to the learning theory

A

It struggles to explain some types of gambling

183
Q

What type of gambling is it harder for the learning theory to explain
Why

A

Addiction to gambling in which the outcome is known some time after placing the bet.
The reward comes a long time after the behaviour so conditioning should be less effective

184
Q

What is a strength of the learning theory

A

It explains why most gamblers cannot stop

185
Q

Explain how the learning theory shows how gambling can be maintained

A

Conditioning is an ‘automatic’ process and doesnt require a gambler to make decisions.
They are not aware they are learning to be addicted.
Conscious desire to give up conflicts with the conditioning.

186
Q

Outline the cycle of gambling addiction

A

Initiation, maintenance, cessation and relapse

187
Q

Addiction begins through what reinforcement

A

Vicarious

188
Q

What explains why so many addicted ga,bless relapse after abstaining

A

Cue reactivity

189
Q

Who suggests that learning theory actually struggles to explain gambling addiction

A

Iain Brown (1987)

190
Q

What part of the cycle does Brown suggest learning theory cannot explain and why

A

Addiction
Many people who gamble and experience the same reinforcements are not addicted.

191
Q

Expectations are central to what part of gambling

A

Initiation

192
Q

What do people who take up gambling expect
How are they wrong

A

The benefits will outweigh the costs
Some people overestimate the benefits and underestimate the costs

193
Q

What is a common unrealistic expectation about gambling

A

How it will help them cope with their emotions

194
Q

People with distorted expectations of gambling are more likely to ____

A

Become addicted

195
Q

Why do gamblers continue to gamble

A

They have a cognitive bias

196
Q

What is a cognitive bias

A

A distortion of attention, memory and thinking.
Arises because of how we process information about the world, especially when we do it quickly.

197
Q

What can cognitive bias lead to

A

Irrational judgements and poor decision-making

198
Q

Who classified cognitive bias into 4 categories

A

Debra Rickwood et al. (2010)

199
Q

List the 4 categories for cognitive bias

A
  1. Skill and judgement
  2. Personal traits / ritual behaviours
  3. Selective recall
  4. Faulty perceptions
200
Q

Outline skill and judgement - 4 categories of cognitive bias

A

Addicted gamblers have an illusion of control which means they overestimate their ability to influence a random event. (Lottery)

201
Q

Outline Personal traits/ritual behaviours - 4 categories of cognitive bias

A

Addicted gamblers believe that they have a greater probability of winning because they are especially lucky or they engaged in some superstitious behaviour (touching a certain item of clothing before a bet)

202
Q

Outline Selective recall - 4 categories of cognitive bias

A

Gamblers can remember the details of their wins but they forget, ignore or minimise their losses, which are often interpreted as unexplainable mysteries.

203
Q

Outline Faulty perceptions - 4 categories of cognitive bias

A

Addicted gamblers have distorted views about the operation of chance, exemplified in the so-called gambler’s fallacy, the belief that a losing streak cannot last and must always be followed by a win

204
Q

What is self-efficacy

A

Refers to the expectations we have about our ability to achieve a desired outcome.

205
Q

Where in the gamblers cycle does self-efficacy play a part

A

A key element in relapse

206
Q

What type of process is self-efficacy
Why

A

A cognitive process
It is based on expectations and perceptions

207
Q

Explain how self-efficacy results in relapse

A

A person has a biased belief that they are not capable of abstaining permanently.
They expect to gamble again.
Sets up a self-fulfilling prophecy.

208
Q

What is self-fulfilling prophecy

A

An individual behaves in a way that confirms their expectations (“I told you so”)
This is in turn reinforced

209
Q

Who investigated cognitive biases in gamblers

A

Mark Griffith (1994)

210
Q

What was Griffith procedure for investigating cognitive biases in gamblers
(KEYWORDS)

A

Used the ‘thinking aloud’ method (introspection) to compare the cognitive processes of regular slot machine gamblers and people who used the machines only occasionally.
Participants had to verbalise all thoughts.
A content analysis classified the thoughts into rational or irrational.
Behavioural measures were also recorded (total winnings)

A semi-structured interview was used to ask participants about the degree of skill required to win on slot machines.

211
Q

Name and describe the interview methods used in Griffiths investigation on cognitive bias in gamblers

A

A semi-structured interview was used to ask participants about the degree of skill required to win on slot machines.

212
Q

What did Griffiths find in his investigation on cognitive biases in gamblers
Wins and verbalisations

A

There was no differences between regular and occasional gamblers in objective behavioural measures (regulars didnt win more money)
Regular gamblers made almost 6x as many irrational verbalisations than the rest (14% compared with 2.5%)

213
Q

What were the regular gamblers prone to in Griffiths investigation on cognitive biases in gamblers

A

They were particularly prone to an illusion of control.

214
Q

What is one strength of the cognitive theory

A

The support for the role of cognitive biases

215
Q

Who researched cognitive biases for the cognitive theory

A

Rosanna michalczuk et al, (2011)

216
Q

What was the method for Michalczuk reserach on cognitive bias in gambling

A

Studies 30 addicted gamblers attending the National Problem Gambling Clinic in the UK.
Compared them with 30 non-gambling control participants.

217
Q

What was the result of Michalczuk research on cognitive bias in gambling

A

The addicted gamblers showed significantly higher levels of gambling-related cognitive biases of all types.
The gamblers were more impulsive and more likely to prefer immediate rewards even when the rewards were smaller than rewards they could gain if they waited.

218
Q

What does impulsive gambling decisions show about the cognitive theory

A

Because addicted gamblers make gambling decisions impulsively, they have a powerful tendency towards biased thinking during play.
Shows a strong cognitive component to gambling addiction

219
Q

What is the counterpoint to Michalczuk’s findings on the link between cognitive bias and gambling addictions

A

Cognitive biases were measured using the Gambling-related cognitions scale (GRCS).
This scores respondents on five types of bias.
The score could mean the gamblers have high frequency biased cognitions (what researchers concluded) or the score might reflect a gambler’s tendency to use their beliefs to justify their behaviour.
Therefore wouldnt be bias at all.

220
Q

Who else’s reserach supports cognitive biases

A

George McCusker and Briege Gettings (1997)

221
Q

What was McCusker and Gettings method when researching cognitive biases

A

Used a modified stroop task.

222
Q

What did McCusker and Gettings find on cognitive bias using a stroop task

A

Addicted gamblers took longer to perform this task than controls but only when the words related to gambling.
They were unable to prevent the word meanings from interfering with the intended task.

223
Q

What is one methodological problem in methods used to assess cognitive bias

A

The use of ‘thinking aloud’ in research

224
Q

How pointed out the issue with ‘thinking aloud’ method

A

Mark Dickerson and John O’Conner (2006)

225
Q

What did Dickerson and O’Conner say about the thinking aloud method

A

What people say in gambling situations does not necessarily represent what they really think.
Off-the-cuff remarks during gambling may not reflect an addicted gamblers real thoughts about chance and skill.

226
Q

Why might cognitive bias not truly explain gambling addiction

A

They are only proximate causes
Have to go further back in the chain of causation to find the ultimate explanation

227
Q

What is drug therapy

A

Treatment involving drugs.

228
Q

What are the three main types of drug therapy for addiction

A

Aversives
Agonists
Antagonists

229
Q

What is the main effect of aversives

A

To produce unpleasant consequences such as vomiting.

230
Q

What type of conditioning are aversives

A

Classical

231
Q

Explain the example of aversives and alcohol

A

Disulfriam is a drug given to alcoholics.
It causes the effects of a severe hangover (especially nausea) 5 mins after an alcoholic drink.
Alcohol is then associated with unpleasant outcomes

232
Q

What are agonists

A

Drug substitutes that control withdrawal syndrome

233
Q

How do agonists work

A

They activate neuron receptors providing a similar effect to the addictive substance

234
Q

Give an example of an agonist
What a re the benefits

A

Methadone is given to heroin addicts
Satisfy cravings, fewer harmful side effects, cleaner.

235
Q

How do antagonists work

A

They treat addiction by blocking receptor sites so that the substance of dependence cannot have its usual effects.
Especially the effect of euphoria

236
Q

Give an example of an antagonist
What else should be done

A

Naltrexone is an opioid antagonist used to treat psychological dependence of heroin addiction.
Other interventions such as counselling should be used alongside drug therapy.

237
Q

How does NRT help nicotine withdrawal

A

It provides the user with a clean, controlled dose of nicotine which operates neurochemical y as an agonist activating nAChRs

238
Q

What steps are taken with NRT to ease symptoms and slow withdrawal

A

Nicotine is reduced over time by reducing the number of mg of nicotine within patches or gum.

239
Q

Are there drug therapies approved for gambling addiction

A

No

240
Q

What is the most promising drug from gambling addicts
What is the type of drug and whats its name

A

Opioid antagonists
Naltrexone

241
Q

What information came out in DSM-5 that has led to the idea of drug therapy for gambling addictions

A

The neurochemical explanation if gambling addiction is that it tap into he same dopamine reward system as drugs.

242
Q

How do opioid antagonists work
Key words and depth

A

They enhance the release of the neurotransmitter GABA in the mesolimbic pathway.
Increased GABA activity reduces the release of dopamine in the nucleus accumbens (and frontal cortex).

243
Q

What is one strength of drug therapy

A

Research shows it is effective

244
Q

Who conducted research on the effectiveness of NRT

A

Jamie Hartmann-Boyce et al. (2018)

245
Q

What was Hartmann-Boyce’s method when looking at NRT effectiveness
How many participants

A

They conducted a meta-analysis of 136 high-quality research studies.
Almost 65,000 participants

246
Q

What did Hartmann-Boyce find about the effectiveness of NRT
Fact

A

All forms of NRT were significantly more effective in helping smokers quit than both placebo and no therapy.
NRT products increased the rate of quitting by 60%.

247
Q

What did Hartmann-Boyces finding also suggest about NRT

A

Research indicated that NRT does not appear to foster dependence

248
Q

What is a counterpoint to Hartmann-Boyce’s findings

A

The researchers only included in their analysis research studies that has been published.
There is a risk of publication bias because published studies are more likely to show ‘positive’ results.

249
Q

What is a strength of drug therapy

A

Addiction becomes less stigmatised through its association with drug therapies.
It encourages the perception that drug addiction has a neurochemical basis.

250
Q

What is the stigma with drug addiction
What can this cause for people with drug addiction

A

That it is a psychological weakness
Can lead to self-blame and depression, making recovery more difficult.

251
Q

What are two more major positives to drug therapy

A

Drugs are cost-effective and dont disrupt peoples lives as much as therapy would

252
Q

What is one limitation of all drug therapies

A

They have side effects

253
Q

What is the biggest risk of side effects in drug therapies

A

Clients will discontinue the therapy even if the side effects are minimal and will be short-lived.
Another reason to go back to the drug

254
Q

What are the common side-effects of NRT

A

Sleep disturbances, gastrointestinal problems, dizziness and headaches.

255
Q

Does drug therapy for gambling addictions have better or worse side effects than for nicotine

A

Worse

256
Q

Explain why the side effects for drug therapy to treat gambling addictions are worse

A

The dose required for naltrexone to have an effect on gambling addiction is much higher than when used to treat opioid addiction.
The side effects are worse.

257
Q

What are the side effects of using Naltrexone on gambling addictions

A

Muscle spasms, anxiety and depression.

258
Q

What must always been considered before drug therapy

A

Side effects should be weighed up against the benefits of drug therapy and the costs / benefits of other therapies.

259
Q

What type of intervention is aversion therapy

A

A behavioural intervention

260
Q

What is behavioural intervention

A

Any treatment based on behaviourist principles of learning such as classical and operant conditioning

261
Q

What is aversion therapy

A

A behavioural treatment based on classical conditioning.
A maladaptive behaviour is paired with an unpleasant stimulus such as a painful electric shock.
Eventually the behaviour is associated with pain without the shock being used.

262
Q

What is it called when you change conditioning

A

Counterconditioning

263
Q

Give an example of aversion therapy

A

Using the drug Disulfriam from alcoholics

264
Q

Explain Disulfriam and alcohol in terms of classical conditioning

A

Through association they become conditioned stimuli producing an expectation of nausea which is a conditioned response

265
Q

When is an electric shock used in aversion therapy

A

Treatment of behavioural addictions and for people who’s medical conditions (e.g. high blood pressure) may be worsened by frequent vomiting.

266
Q

Explain how electric shock therapy is performed on gambling addicts

A

An addicted gambler thinks of phrases that relate to their gambling behaviour and writes them down along with non-gambling behaviours on card.
The client reads out each card and when they get to a gambling-related phrase they are given a 2 second electric shock via a device attached to their wrist.

267
Q

What is the key rule with electric shock therapy

A

Should be painful but not distressing

268
Q

What is the pain called before and after the therapy

A

It was an unconditioned response and a neutral stimuli
Now a conditioned stimuli

269
Q

When was aversion therapy most popular

A

60s and 70s

270
Q

What therapy has take over aversion therapy

A

Covert sensitisation

271
Q

What type of conditioning is covert sensitisation based on

A

Classical

272
Q

What is covert sensitisation

A

A form of aversion therapy based on classical conditioning.
A client imagines an unpleasant stimulus and associates this with a maladaptive behaviour.

273
Q

What is the difference between aversion therapy and covert sensitisation

A

In aversion therapy the unpleasant stimulus is actually experienced
In covert sensitisation the client imagines how it would feel

274
Q

Describe the process of covert sensitisation
Example

A

Client relaxes
Therapist reads from a script instructing the client to imagine an aversive situation.
The client sees themselves doing the addictive habit followed by imagining the most unpleasant consequences.
Towards the end of the session the client then imagines a scene where they give up the addictive substance and experience relief.

Example: tobacco and vomiting

275
Q

What makes covert sensitisation more effective
How is this achieved

A

The more vivid this imaginary scene is the better
Therapists go into graphic detail about the imagery including sights, smells, sounds and physical movements involved.

276
Q

Who gives a good example of covert sensitisation

A

Mary McMurran (1994)

277
Q

What was Mary McMurrans example of covert sensitisation

A

A habitual user of slot machines had a phobia of snakes.
Got them to imagine the pay out was snakes and not cash.

278
Q

What is a limitation to the evidence on aversion therapy

A

Studies have methodological problems.

279
Q

Who reviewed the methodological problems in studies on aversion therapies

A

Peter Hajek and Lindsay Stead (2001)

280
Q

How many studies on what did Hajek and Stead review on evidence for aversion therapy
What did Hajek and Stead conclude

A

25 studies on aversion therapy for nicotine addiction.
Concluded it was impossible to judge the effectiveness of aversion therapy as most of the studies had ‘glaring’ methodological problems,s.

281
Q

Give an example of a methodological problem in research on the effectiveness of aversion therapies

A

There was a failure to ‘blind’ the procedures, so the researchers knew which participants received therapy or placebo

282
Q

What are two general limitations to aversion therapy

A

Lack of long-term benefits
It is unethical

283
Q

Who researched the longevity of aversion therapy

A

Richard Fuller et al. (1986)

284
Q

What was Fullers method when investigating the longevity of aversion therapy’s benefits

A

Gave one group who were addicted to alcohol Disulfriam and the others a placebo every day for a year.
Both groups also had weekly counselling sessions for 6 months

285
Q

What was Fullers findings when investigation the longevity of aversion therapy

A

There was no significant difference in total abstinence from drinking between these groups after one year.

286
Q

Do many people complete aversion therapy

A

Drop out rates are really high

287
Q

What are the ethical issues with aversion therapy

A

It may cause physical and / or psychological harm

288
Q

Why might someone argue that aversion therapy is ethical

A

Self-selected small electric shocks may be painful but not life-threatening.

289
Q

What is one strength for covert sensitisation

A

There is research support

290
Q

Who researched the effectiveness of covert sensitisation

A

Nathaniel McConaghy et al. (1983)

291
Q

What was McConaghy’s method for researching the effectiveness of covert sensitisation

A

They compared cover sensitisation and electric shock aversion therapy for gambling addiction.

292
Q

What was McConaghy’s findings when researching the effectiveness of covert sensitisation
Fact

A

After one year, those with covert sensitisation were significantly more likely to have reduced their gambling.
90% of covert sensitisation participants reduced gambling compared to just 30% that underwent aversion therapy.
Covert sensitisation patients also reported experiencing fewer and less intense gambling cravings.

293
Q

What is one limitation of research on covert sensitisation

A

Many studies of covert sensitisation do not include a suitable comparison group.

294
Q

What is a limitation to McConaghy’s research on the effectiveness of covert sensitisation

A

It did not include a suitable comparison group

295
Q

What is the missing comparison group in a lot of studies investigating covert sensitisation or aversion therapy

A

A non-behavioural therapy group.
Usually only compare aversion therapy to covert sensitisation.

296
Q

What does CBT address that neither covert sensitisation or aversion therapy do

A

Addiction has many non-learning causes (cognitive factors)

297
Q

Does covert sensitisation or aversion therapy cure addiction

A

No

298
Q

What can covert sensitisation lead to
How can this be solved

A

Symptoms substitution
May appear to recover but the issue that caused addiction remains and new symptoms start to appear.
Covert sensitisation can be used to treat those aswell

299
Q

What is cognitive behavioural therapy (CBT)

A

A method for treating mental disorders based on both cognitive and behavioural techniques.
From the cognitive viewpoint the therapy aims to deal with thinking, such as challenging negative thoughts.
The therapy also includes behavioural techniques.

300
Q

What are the two indispensable elements to a CBT program

A

Functional analysis
Skills training

301
Q

What is functional analysis in CBT

A

It identifies the cognitive biases that underlie addiction, replacing the cognitive biases with more adaptive ways of thinking

302
Q

Is functional analysis cognitive or behavioural

A

Cognitive

303
Q

What is skill training in CBT

A

Helps a client to develop coping behaviours to avoid the high-risk situations that usually maintain addictions or trigger relapses

304
Q

Is skills training cognitive or behavioural

A

Behavioural

305
Q

How does CBT start - functional analysis

A

Starts with a client and therapist together identifying the high-risk situations in which the client is likely to gamble or use a substance of addiction.
The therapist reflects on what the client is thinking before, during and after such a situation.

306
Q

What is extremely important in CBT - functional analysis

A

That there is a high quality client-therapist relationship

307
Q

What are good qualities of a patient-therapist relationship - functional analysis

A

Warm, collaborative and responsive

308
Q

What must a client-therapist relationship not be and why - functional analysis

A

Cosy as the therapist must challenge the client’s biased cognitions and not accept them

309
Q

What does cognitive restructuring do - functional analysis
Example with gambling

A

Aims to change a client’s addiction-related cognitive biases.
Addresses the clients faulty beliefs.
E.g. probability

310
Q

What does the therapist does with a clients misbeliefs - functional analysis

A

Confronts and challenges them

311
Q

What does functional analysis do in the early stages of therapy

A

It helps the client identify the triggers for their actions.

312
Q

What is functional analysis useful for later in therapy

A

Helping a client to work out their circumstances in which they are still having problems with coping and what further training skills may be needed

313
Q

What do most people seeking therapy for addiction also have - skill training

A

A huge range of problems but only one way of coping with them - addiction

314
Q

What two types of skills can be used in skill training

A

Specific skills and social skills

315
Q

Is CBT a broad or narrow treatment

A

Broad

316
Q

Why is CBT considered broad-spectrum

A

It focuses on wider ascpetcs of a clients life that are related to his or her addiction.

317
Q

What training can be used for people that turn to alcohol when angry

A

Anger management training

318
Q

Give an example of what functional analysis may review and what could be used in skills training to solve it

A

Functional analysis may reveal that a client cannot cope with a situation that triggers alcohol use.
Assertiveness training could be used to help a client confront interpersonal conflicts in a controlled and rational way.

319
Q

How can social skills training help a recovering alcoholic

A

It can help them learn how to refuse alcohol with minimum fuss in ways that avoid embarrassment at social gatherings.

320
Q

How does a therapist usually introduce a new skill

A

With an explanation of the reasoning behind learning a new skill.

321
Q

How are skills improved before the client uses them on their own in a high-risk situation

A

The therapist models the behaviour. The client imitates in role play.
Constant ‘tell and show’

322
Q

What are two limitations of CBT

A

It may only be effective in the short-term
Many clients drop out of CBT

323
Q

Who investigated the longevity of CBT

A

Sean Cowlishaw et al. (2012)

324
Q

What was Cowlishaw’s method when investigating the longevity of CBT

A

Conducted a meta-analysis of 11 studies comparing CBT for gambling with control conditions.

325
Q

What was Cowlishaw’s findings on the longevity of CBT

A

Showed that CBT had medium to very large effects in reducing gambling behaviour for period of up to 3 months after treatment.
After 9 to 12 months there were no significant differences in outcomes between the CBT and control groups.

326
Q

Who conducted research that combatted Cowlishaw’s findings on the longevity of CBT

A

Nancy Petry et al. (2006)

327
Q

What was Petry’s method when investigating the longevity of CBT

A

Randomly allocated pathological gamblers to either a control group (Gamblers anonymous meetings) or a treatment condition (GA meetings plus an eight-session individual CBT programme).

328
Q

What was Petry’s findings when researching the longevity of CBT

A

The treatment clients were gambling significantly less than the control participants 12 months later.

329
Q

What is extremely reliable about Petry’s investigation into the longevity of CBT

A

The study had high internal validity due to random allocation and there was no significant difference in the extent of their gambling at the start

330
Q

Who conducted an investigation into the drop out rates of CBT

A

Pim Cuijpers et al. (2008)

331
Q

What did Cuijper’s state about dropout rates for CBT

A

Drop-out rates in CBT treatment groups can be up to 5x higher than for other forms of therapy.

332
Q

Why might there be such high-drop out rates for CBT

A

CBT is a demanding form of therapy
Clients often seek CBT because a life crisis caused by addiction has driven them to it. Once the initial crisis is resolved they give up CBT when there are smaller underlying issues at hand.

333
Q

What is one strength of CBT

A

Very useful in preventing relapse

334
Q

How does CBT approach relapses

A

It is a very realistic therapy and incorporates the likelihood of relapse
Replace is viewed as an opportunity for further cognitive restructuring and learning rather than as a failure.

335
Q

What is theory of planned behaviour (TPB)

A

How we can change out behaviour deliberately through rational decisions - we evaluate the positive and negative consequences

336
Q

Who came up with the theory of planned behaviour

A

Icek Ajzen (1985, 1991)

337
Q

What does TPB assert about our behaviour

A

It can be predicted from our intentions.

338
Q

What is the aim for TPB and addiction

A

To link intentions and changes in behaviour

339
Q

What 3 principles does TPB suggest our intentions to use drugs arise from

A

Our personal attitudes
Subjective norms
Perceived behavioural control

340
Q

What are an addicted persons attitudes a combination of

A

Favourable and unfavourable opinions about their addiction

341
Q

How are personal attitudes formed for addiction

A

By the person evaluating the positive and negative consequences of their addiction-related behaviour

342
Q

When attitudes become unfavourable what happens to addiction

A

Reduced interest in addiction-related behaviour

343
Q

What are subjective norms in addiction

A

The addicted person’s beliefs are about whether those who matter most to them approve or disapprove of their addicted behaviour

344
Q

What are subjective norm beliefs based on in addiction

A

What an addicted person believes to be ‘normal’ behaviour.

345
Q

What does an addicted person consider about their friends and family

A

What they would think if they knew about their addiction

346
Q

If an addicted person knows their friends and family dislike their addiction what will the affect on the addicted person be

A

It will lead them to form an intention not to gamble, and therefore make them less likely to gamble.

347
Q

What is important about the source of the information an addicted person sees.
Why?

A

It has to be credible
Our subjective norms are most influenced by views of people we respect

348
Q

What is perceived behavioural control

A

How much control we believe we have over our own behaviour
Self-efficacy for example.

349
Q

What does a gamblers believe on how easy it is to give up depends upon in perceived behavioural control

A

Depends on their perception of the resources available to them, both external and internal.

350
Q

According to TPB what are the two possible effects that perceived behavioural control can have
Are these direct or indirect influences on behaviour

A
  1. It can influence our behaviour indirectly via our intentions to behave. The more i believe i can stop gambling the more likely i will.
  2. The greater my perceived control over my gambling the longer and harder i will try to stop. The only TPB component that will directly influence behaviour
351
Q

Increasing a gamblers self-efficacy will result in what?

A

Could help them quit and/or avoid relapse

352
Q

What should be made clear to an individual going through withdrawal

A

It will require willpower

353
Q

How can you increase the self-efficacy of someone trying to quit an addictive substance

A

Encouraging an optimistic outlook and confidence in their ability not to gamble.

354
Q

What is one strength of TPB

A

There is research evidence to support it

355
Q

Who conducted research on TPB

A

Matin Hagger et al. (2011)

356
Q

What was Hagger’s method when reseraching TPB

A

486 participants completed questionnaires about their alcohol-related behaviours.
They completed the same questionnaires after one month and after three months.

357
Q

What did Hagger’s investigation on TPB find?

A

Personal attitudes, subjective norms and perceived behavioural control all correlated significantly with the intention to limit drinking to the guideline number of units.

358
Q

What did Hagger’s investigation also find on intention

A

Intentions were also found to predict the number of units actually consumed after one and three months.

359
Q

What did Hagger’s investigation find out about perceived behavioural control

A

Perceived behavioural control predicted actual unit consumption directly and not just intention.

360
Q

What is the counterpoint to Hagger’s investigation on TPB

A

The study failed to predict some alcohol-related behaviours.

361
Q

What alcohol-related behaviours failed to be predicted in Hagger’s research on TPB

A

Attitudes, norms, control and intentions did not correlated significantly with the number of binge-drinking sessions after one and three months.

362
Q

What does Hagger’s findings suggest about the success of TPB

A

It may depend on the type of addiction-related behaviour being measured.

363
Q

What are the limitations of TPB

A

Short-term effects only
TPB cannot account for the intention-behaviour gap.

364
Q

Who researched the longevity of TPB

A

Rosie McEachan et al. (2011)

365
Q

What was McEachan’s method when researching the longevity of TPB

A

Conducted a meta-analysis of 237 tests of the TPB in predicting health behaviours including addiction-related ones

366
Q

What did McEachan find about the longevity of TPB

A

The strength of the correlation between intentions and behaviour varied according to the length of time between the two.
Intention to stop drinking can predict actually giving up drinking but only if the time between intention and bahaviour is less than about 5 weeks.

367
Q

What does McEachan’s results for longevity of TPB suggest about intentions being used for predictions

A

Intentions may not predict changes to addiction-related behaviour in the long-term.

368
Q

Who investigated the intention-behaviour gap

A

Rohan Miller and Gwyneth Howell (2005)

369
Q

What did Miller and Howell study in relation to intention-behaviour gap

A

They studies the gambling behaviour of underage teens.

370
Q

What did Miller and Howell find about the intention-behaviour gap in TPB

A

Strong support for some parts of the TPB but the key element of the TPB was not supported.
Intentions were not related tot he actual gambling behaviour.

371
Q

What does TPB claim about decisions being made
Why is this a flaw

A

Claims that addiction is the result of rational decisions
Decisions may not be rational as many factors including emotions and stress can make decision making irrational and this is not explained by TPB

372
Q

Who notices that smoker’s behaviour changes during the time that they were trying to quit

A

James Prochaska and Carlo DiClemente (1983)

373
Q

Who came up with the six-stage model of behaviour change

A

It is Prochaska’s six-stage model

374
Q

What does Prochaska’s six-stage model recognise is not the case about overcoming addiction

A

It recognises that is does not happen quickly or in a tidy linear order from start to finish.

375
Q

What type of process is Prochaska’s six-stage model

A

It is not a single event but a cyclical process.

376
Q

Describe how Prochaska’s six-stage model is a cyclical process

A

Clients progress through stages but they also return to previous ones, and some stages may be missed out altogether.

377
Q

What two major insights is Prochaska’s six-stage model based on

A
  1. People who are addicted differ in how ready they are to change their behaviour.
  2. The usefulness of treatment intervention depends on the stage the person is currently in.
378
Q

Name the six stages in Prochaska’s six-stage model

A
  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
  6. Termination
379
Q

Draw the diagram for Prochaska’s six-stage model

A
380
Q

What is Prochaska’s six-stage model
Definition / summary

A

This explains the stages people go through to change their behaviour. It identifies six stages of change, from not considering it at all to making permanent changes. The stages are not necessarily followed in a linear order.

381
Q

What are people doing in the stage of precontemplation

A

Not thinking about changing their addiction-related behaviour in the near future.

382
Q

How long must a person be not wanting to change their addiction for in precontemplation

A

The next 6 months

383
Q

Why might someone be in the stage of precontemplation

A

Denial and/or demotivation

384
Q

What is the intervention in the stage of precontemplation

A

Intervention should focus on helping the person to consider the need for change

385
Q

What is a person thinking at the contemplation stage

A

They are thinking about making a change to their behaviour.

386
Q

What is the time period for contemplation

A

Changing behaviour in the next 6 months.

387
Q

Does a person in the contemplation stage need to have decided to make change

A

No they are just increasingly aware of the need for change.

388
Q

How long can people remain in the contemplation stage

A

People can remain in a chronic stage of contemplation for a long time

389
Q

What is the most useful intervention in the contemplation stage

A

Help the person finally see how the pros of overcoming addiction outweigh the cons

390
Q

What does a person think in the preparation stage

A

The individual believes that the benefits are greater than the costs. They decide to change their addiction-related behaviour

391
Q

In what time period has a person decided to make change in the preparation stage

A

They will change their addiction-related behaviour some time in the next month.

392
Q

What have people not decided when in the preparation stage

A

Haven’t yet decided exactly how and when to change.

393
Q

What is the most useful form of intervention in the preparation stage

A

To support in constructing a plan, or in presenting them with some options.
Example: seeing a drugs counsellor or making a gp appointment

394
Q

What are people doing in the action stage

A

People at this stage have done something to change their behaviour.

395
Q

In the action stage what time period does someone have to have made a change to their behaviour

A

In the last 6 months

396
Q

What type of therapies may be effective in the action stage

A

Cognitive and behaviour therapies

397
Q

What informal action may someone in the action stage take.
Give 2 examples

A

Cut up their cigarettes
Pour all the alcohol in the house down the sink

398
Q

The actions a person takes in the action stage must do what

A

Substantially reduce their risk.

399
Q

What is effective intervention in the action stage

A

Focuses on developing the coping skills the client will need to quit and maintain their change of behaviour into the next stage.

400
Q

What is a person doing in the maintenance stage

A

The person has maintained some change of behaviour

401
Q

How long does someone have to have changed their addictive behaviour for to be in the maintenance stage

A

More than 6 months

402
Q

What is the general focus on in the maintenance stage
What must be avoided

A

Relapse prevention
Avoiding situations where cues might trigger addiction

403
Q

What happens to a persons confidence in the maintenance stage

A

Become more confident that abstaining can be continued in the long term because it is becoming a way of life

404
Q

What does intervention focus on in the maintenance stage

A

Relapse prevention, and aims to help the client to apply the coping skills they have learned and use the sources of support available to them.

405
Q

What is a person doing at the termination stage

A

Newly acquired behaviours such as abstinence become automatic.
The person no longer returns to addictive behaviours to cope with anxiety, stress or loneliness.

406
Q

Do all people reach termination

A

This stage may not be possible or realistic for some people to achieve

407
Q

What is the most appropriate goal for many going through withdrawal

A

To prolong maintenance for as long as they can, accepting that relapse is inevitable but providing the person with the skills to work through the earlier stages of the process quickly.

408
Q

Hat is the most effective intervention in the termination stage

A

No intervention is required.

409
Q

What are the strengths of Prochaska’s six-stage model

A

The model views recovery as a dynamic process
The model views relapse realistically

410
Q

What have earlier theories suggested about recovery from addiction
Is this view still held by many people

A

It is a single all-or-nothing event
Yes

411
Q

What does the six-stage model emphasise about recovery helping it be viewed as a dynamic process

A

The importance of time, overcoming addiction is a continuing process.
People can skip stages or revisit old ones.

412
Q

What is a counterpoint to the six-stages being a dynamic process

A

The stages themselves have been criticised for being arbitrary.
There is no research evidence to distinguish one stage from another.

413
Q

Who argued against the need for six-stages

A

Pa Kraft et al. (1999)

414
Q

What did Kraft argue about the six stages
How many stages does he suggest

A

They can be reduced or just two useful ones,
Precontemplation then the other stages grouped together.

415
Q

What are the implications in the six-stage model Kraft highlights

A

According to Prochaska’s six-stage model, each stage is matched with a particular type of intervention.
Suggests Prochaska’s six-stage model has little usefulness both for understanding changes over time and for treatment recommendations

416
Q

Who said ‘Relapse is the rule rather than the exception’

A

Di Clemente et al. (2004)

417
Q

What did DiClemente et al state about relapse

A

‘Relapse is the rule rather than the exception’

418
Q

Does Prochaska’s six-stage model still take relapse seriously
Why / how is this shown in the model

A

Yes it is seen as more than just as slop.
Does not underestimate its potential to blow change entirely off course.
This is shown by being able to jump back multiple steps

419
Q

What term best describes the six-stage model in terms of acknowledging addiction may require several attempts
Why

A

It has face validity.
More acceptable as it’s realising about relapse

420
Q

What is a limitation to Prochaska’s six-stage model

A

There is evidence cha;ending the model

421
Q

Who conducted a review of NICE and Prochaska’s six-stage model

A

David Taylor et al. (2006)

422
Q

What was Taylors method when challenging the six-stage model

A

Analysed 24 reviews and meta-analyses of the six-stage model

423
Q

What 2 things did Taylors conclude after his meta-analysis on Prochaska’s six-stage model

A
  1. The model was no more effective than appropriate alternatives (TPB) in changing nicotine addiction-related behaviours.
  2. The key concept of defined stages in behaviour change could not be validated by Avaliable data.
424
Q

What type of change is Prochaska’s six-stage model of

A

Model of behaviour change

425
Q

How can it be argued that Prochaska’s six-stage model is not of behaviour change

A

Clients can move between stages and can go backwards regardless of whether their behaviour changes or not

426
Q

How is it argued that Prochaska’s six-stage model is of behaviour change

A

It emphasises that change unfolds over time and depends on whether someone is ready to change.

paper 3 - psychology (4 decks)

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